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Jing Liu - One of the best experts on this subject based on the ideXlab platform.
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Lung ultrasonography for the diagnosis of meconium aspiration syndrome of the newborn infants
Chinese Journal of Applied Clinical Pediatrics, 2016Co-Authors: Jing Liu, Haiying Cao, Shuiwen Chen, Yan WangAbstract:Objective To investigate the diagnostic value of lung ultrasonography for meconium aspiration syndrome (MAS). Methods From August 2014 to October 2015, a total of 67 cases of MAS patients were included in this study based on the medical history, typical clinical symptoms and chest X ray findings.The control group comprised 100 neonates without pulmonary disease.In a resting state, each patient was placed in a supine, lateral recumbent, or prone position.Using the anterior and posterior Axillary Lines as boundaries, each side of the lung was divided into 3 regions: anterior, lateral and posterior.The probe was held perpendicular or parallel to the ribs, and each region of both sides of the lung was scanned. Results In this study, the main lung ultrasonographic findings in MAS patients were as follows: (1) Lung consolidation with air bronchograms, which was found in all patients.Generally, the large area of lung consolidation with irregular margins was seen in severe MAS patients while the small area of lung consolidation was seen in mild patients.(2)Pleural line anomalies and the disappearance of the A-Lines, which were found in all patients.(3)Atelectasis, which was found in 12 severe cases(17.9%), with severe massive atelectasis and visible lung pulse.(4)Pleural effusion, which was found in 9 cases (13.4%) including mild or severe patients.(5)Alveolar-interstitial syndrome (AIS) or B-line in the non-consolidation area was found in all patients. Conclusions There were speci-fic imaging findings in lung ultrasound in MAS patients. Lung ultrasonography can be used for the routine diagnosis of MAS because of its accuracy, reliability, low-cost and simplicity, no risk of radiation damage as well as it is convenience to observe and understand the dynamic changes of the patients′ condition timely. Key words: Lung ultrasonography; Meconium aspiration syndrome; Infant, newborn
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the diagnosis of neonatal pulmonary atelectasis using lung ultrasonography
Chest, 2015Co-Authors: Jing Liu, Shuiwen Chen, Fang Liu, Xiangyong Kong, Zhichun FengAbstract:Abstract BACKGROUND: Ultrasonography has been used for the diagnosis of many kinds of lung conditions, but few studies have investigated ultrasound for the diagnosis of neonatal pulmonary atelectasis (NAP). In this study, we evaluated the usefulness of lung ultrasonography for the diagnosis of NPA. METHODS: From May 2012 to December 2013, 80 neonates with NPA and 50 neonates without lung disease were enrolled in this study. Each lung of every infant was divided into the anterior, lateral, and posterior regions by the anterior and posterior Axillary Lines. Each region was scanned carefully with the probe perpendicular or parallel to the ribs. The ultrasound findings were confirmed by chest radiograph (CXR) or CT scan. RESULTS: Sixty of the 80 patients with signs of NPA on lung ultrasound also had signs of NPA on CXR (termed focal-type atelectasis), and the other 20 patients had signs of NPA on chest CT scan while there were no abnormal findings on CXR (termed occult lung atelectasis). In patients with NPA, the main ultrasound findings were large areas of lung consolidation with clearly demarcated borders, air bronchograms, pleural line abnormalities, and absence of A-Lines, as well as the presence of lung pulse and absence of lung sliding on real-time ultrasound. The sensitivity of lung ultrasonography for the diagnosis of NPA was 100%, whereas the sensitivity of CXR was 75%. Large areas of lung consolidation with clearly demarcated borders were only observed in patients with NPA. CONCLUSIONS: Lung ultrasonography is an accurate and reliable method for diagnosing NPA; most importantly, it can find those occult lung atelectasis that could not be detected on CXR. Routine lung ultrasonography is a useful method of diagnosing or excluding NPA in neonates.
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diagnosis of neonatal transient tachypnea and its differentiation from respiratory distress syndrome using lung ultrasound
Medicine, 2014Co-Authors: Jing Liu, Changshua Yang, Ya Wang, Junji HuangAbstract:Transient tachypnea of the newborn (TTN) is one of the most common causes of perinatal dyspnea and is traditionally diagnosed by chest x-ray. This study aimed to explore the diagnostic value of lung ultrasonography (LUS) for TTN as well as differentiate it from respiratory distress syndrome (RDS) by using LUS. From January 2013 to February 2014, 60 infants who were diagnosed with TTN based on medical history, clinical manifestations, arterial blood gas analysis, and chest radiography were recruited to the study group. During the same period, 40 hospitalized neonates with nonlung diseases and 20 patients with RDS were recruited to the control group. In a quiet state, infants were placed in the supine, lateral, or prone position for the examination. Each lung of every infant was divided into 3 regions: the anterior, lateral, and posterior regions as bordered by the anterior Axillary and posterior Axillary Lines. The probe was placed perpendicular to the ribs. Each region of both the lungs was carefully scanned. The common ultrasonographic manifestations of TTN were double-lung point (DLP), interstitial syndromes or white lungs, pleural line abnormalities, and A-line disappearance. A small number of infants (20%) with TTN exhibited pleural effusions, whereas the main ultrasonographic manifestation of RDS was lung consolidation with air bronchograms, which does not occur in TTN. The sensitivity and specificity of DLP for the diagnosis of TTN were 76.7% and 100%, respectively. LUS can accurately and reliably diagnose TTN. The DLP and lung consolidation possess great value in the diagnosis and differential diagnosis of TTN with RDS. Thus, we believe that LUS can be widely used in neonatal intensive care units.
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value of lung ultrasound on diagnosing transient tachypnea of newborn
Chinese Journal of Applied Clinical Pediatrics, 2013Co-Authors: Jing Liu, Huawei Wang, Jing Liang, L I Jingya, Meng Xing, Haiying Cao, Changshua YangAbstract:Objective To evaluate the diagnostic value of lung ultrasonography for transient tachypnea of newborn (TTN). Methods From January to December 2014, a total of 1 358 children were hospitalized in the Neonatal Intensive Care Center and underwent lung ultrasonography at the Bayi Children's Hospital, Beijing Military General Hospital.According to the patients' medical histories, clinical presentations, arterial blood gas analysis, chest X-ray examinations, and lung ultrasound examinations, there were 412 cases of patients without pulmonary lesions, 228 cases of TTN, 358 cases of respiratory distress syndrome (RDS), 85 cases of meconium aspiration syndrome (MAS), 215 cases of infectious pneumonia, and 60 other cases at the time of hospital admission.In a resting state, the patients were placed in a supine, lateral recumbent or prone position.By using the anterior and posterior Axillary Lines as boundaries, the lung was divided into 3 regions: anterior, lateral, and posterior.The probe was perpendicular or parallel to the ribs, and each region of both sides of the lung was scanned.The scan results were compared to the conventional chest X-ray results. Results The main ultrasonic characteristics of TTN was pulmonary edema.In severe cases, the ultrasound showed a white lung or compact B-line.Compact B-line had 100.0% sensitivity and 95.3% specificity for diagnosing severe TTN.Mild TTN presented as pulmonary interstitial syndrome or double lung point.Double lung point might appear during the recovery period of mild TTN or other diseases, such as RDS, MAS, and pneumonia, among others.Lung consolidation and air bronchogram were not observed in patients with TTN.Pleural effusion might occur in a variety of lung diseases, and pleural line abnormality, A-line disappearance, and B-line or pulmonary interstitial syndrome were common ultrasonic manifestations of a variety of lung diseases. Conclusions Ultrasonic diagnosis of TTN, mainly based on pulmonary edema without lung consolidation and air bronchogram, is accuracy and reliable; however, double lung point is not a specific sign of TTN, whereas the identification of a white lung and compact B-line is a sensitive and specific sign of severe TTN. Key words: Transient tachypnea; Lung ultrasound; Infant, newborn
J M Beattie - One of the best experts on this subject based on the ideXlab platform.
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Video-assisted thoracoscopic sympathectomy for severe intractable angina.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 1999Co-Authors: S S Khogali, M Miller, P B Rajesh, R G Murray, J M BeattieAbstract:Endoscopic trans-thoracic sympathectomy is a well documented, safe and successful treatment for palmar and Axillary hyperhidrosis. This may also be helpful in the management of patients with intractable angina and advanced coronary disease unsuitable for coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA). We evaluated video assisted thoracoscopic sympathectomy (VATS) in such patients with the aim of improving symptoms and quality of life. Video assisted thoracoscopic sympathectomy, a minimally invasive procedure, was performed under general anaesthesia with alternating single lung ventilation. Three stab incisions were made at the level of the fourth intercostal space in the anterior and posterior Axillary Lines, and at the fifth intercostal space in the mid-Axillary line through which an extensive thoracic sympathectomy was performed to include second to the fourth ganglia, bilaterally. A total of 16 patients aged 46-76 (mean 61) years were assessed for VATS. Of these 10 patients had the procedure performed; nine with previous CABG and one with diffuse coronary disease. Six patients were excluded because of an evolving MI (n = 1), left ventricular ejection fraction (LVEF) < 30% (n = 2), and chronic stable angina with no objective evidence of ischaemia (n = 3). All 10 patients had marked symptomatic improvement with reduction of both angina frequency and intensity of attacks. Mean follow-up period 11.5 months. Exercise tolerance and time to onset of angina measured on exercise treadmill was significantly increased post-VATS (P = 0.028) and maintained 1 year post-operative. VATS was associated with both reduction in angina symptoms and an increase in exercise time to onset of angina. An improved quality of life was evident.
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Video-assisted thoracoscopic sympathectomy for severe intractable angina
European Journal of Cardio-Thoracic Surgery, 1999Co-Authors: S S Khogali, P B Rajesh, R G Murray, Michael J. Miller, J M BeattieAbstract:Objective: Endoscopic trans-thoracic sympathectomy is a well documented, safe and successful treatment for palmar and Axillary hyperhidrosis. This may also be helpful in the management of patients with intractable angina and advanced coronary disease unsuitable for coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA). We evaluated video assisted thoracoscopic sympathectomy (VATS) in such patients with the aim of improving symptoms and quality of life. Methods: Video assisted thoracoscopic sympathectomy, a minimally invasive procedure, was performed under general anaesthesia with alternating single lung ventilation. Three stab incisions were made at the level of the fourth intercostal space in the anterior and posterior Axillary Lines, and at the fifth intercostal space in the mid-Axillary line through which an extensive thoracic sympathectomy was performed to include second to the fourth ganglia, bilaterally. Results: A total of 16 patients aged 46‐76 (mean 61) years were assessed for VATS. Of these 10 patients had the procedure performed; nine with previous CABG and one with diffuse coronary disease. Six patients were excluded because of an evolving MI (na 1), left ventricular ejection fractionOLVEFU , 30% (na 2), and chronic stable angina with no objective evidence of ischaemia (na 3). All 10 patients had marked symptomatic improvement with reduction of both angina frequency and intensity of attacks. Mean follow-up period 11.5 months. Exercise tolerance and time to onset of angina measured on exercise treadmill was significantly increased post-VATS (Pa 0:028) and maintained 1 year post-operative. Conclusion: VATS was associated with both reduction in angina symptoms and an increase in exercise time to onset of angina. An improved quality of life was evident. q 1999 Elsevier Science B.V. All rights reserved.
Ugur Kocer - One of the best experts on this subject based on the ideXlab platform.
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alternative method for the reconstruction of meningomyelocele defects v y rotation and advancement flap
Journal of Neurosurgery, 2015Co-Authors: Yuksel Kankaya, Nezih Sungur, Ozlem Colak Aslan, Kadri Ozer, Mustafa Gurhan Ulusoy, Mete Karatay, Melike Oruc, Koray Gursoy, Onder Karaaslan, Ugur KocerAbstract:OBJECT Skin grafts, skin flaps, fasciocutaneous flaps, muscle flaps, and musculocutaneous flaps have been used for closure of large meningomyelocele (MMC) defects that cannot be closed primarily. The V-Y rotation advancement flap technique has been used successfully for the reconstruction of defects in different areas of the body. In the present study, the authors report on their novel use of this technique in both a binary and a quadruple (butterfly) flap manner for closure of large MMC defects. They also present an algorithm that they developed for the evaluation of MMC defects. METHODS Between January 2011 and November 2013, 17 patients (13 girls and 4 boys) with extremely large MMC defects that could not be repaired by direct primary closure underwent reconstruction of the defects with binary and quadruple V-Y rotation and advancement flaps. With the patient prone, the Axillary apices, the most craniad point of the intergluteal sulcus, and the posterior Axillary Lines were marked, and a rectangular ar...
Haofei Wang - One of the best experts on this subject based on the ideXlab platform.
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Unidirectionally progressive resection of lower right lung cancer under video-assisted thoracoscopy
Journal of Thoracic Disease, 2013Co-Authors: Kaican Cai, Pengfei Ren, Ruijun Cai, Gang Xiong, Haofei WangAbstract:The surgery is performed under general anesthesia with double-lumen endotracheal intubation. The patient is placed in a 90-degree position lying on the unaffected side. An approximately 1.5-cm observation port is created in the 7th intercostal space between the middle and anterior Axillary Lines, an approximately 4-cm working port in the 4th intercostal space between the anterior Axillary line and the midclavicular line, and an approximately 1.5-cm auxiliary port in the 9th intercostal space between the posterior Axillary line and the subscapular line. The operator stands in front of the patient, manipulating the endoscopic instruments while watching the monitor. Surgical procedure: since the patient has right lower lung cancer, a unidirectional procedure is adopted for the surgery, in which the layers of structure are treated one after another until the fissure from a single direction through the working port. Hence, the pulmonary vein, bronchi, pulmonary artery and the poorly developed fissure of the right lower lobe are treated successively during lobectomy. The vessels, bronchi and fissures are cut using an endoscopic linear stapler or the Hemolock clips. The resected lobe is placed into a size 8 sterile glove and retrieved through the working port to prevent contamination of the chest incision by any tumor tissue. Mediastinal lymph node dissection is performed at the end.
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Unidirectionally progressive resection of lower right lung cancer under video-assisted thoracoscopy.
Journal of thoracic disease, 2013Co-Authors: Kaican Cai, Pengfei Ren, Ruijun Cai, Gang Xiong, Haofei WangAbstract:The surgery is performed under general anesthesia with double-lumen endotracheal intubation. The patient is placed in a 90-degree position lying on the unaffected side. An approximately 1.5-cm observation port is created in the 7th intercostal space between the middle and anterior Axillary Lines, an approximately 4-cm working port in the 4th intercostal space between the anterior Axillary line and the midclavicular line, and an approximately 1.5-cm auxiliary port in the 9th intercostal space between the posterior Axillary line and the subscapular line. The operator stands in front of the patient, manipulating the endoscopic instruments while watching the monitor. since the patient has right lower lung cancer, a unidirectional procedure is adopted for the surgery, in which the layers of structure are treated one after another until the fissure from a single direction through the working port. Hence, the pulmonary vein, bronchi, pulmonary artery and the poorly developed fissure of the right lower lobe are treated successively during lobectomy. The vessels, bronchi and fissures are cut using an endoscopic linear stapler or the Hemolock clips. The resected lobe is placed into a size 8 sterile glove and retrieved through the working port to prevent contamination of the chest incision by any tumor tissue. Mediastinal lymph node dissection is performed at the end.
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Unidirectionally progressive left pneumonectomy & mediastinal lymph node dissection.
Journal of thoracic disease, 2013Co-Authors: Kaican Cai, Pengfei Ren, Gang Xiong, Haofei Wang, Siyang Feng, Zhiyong Huang, Ziliang ZhangAbstract:The patient has lower left lung tumor and adenocarcinoma at the openings of both upper and lower left lung. Preoperative bronchoscopic biopsy has confirmed the diagnosis. The surgical approach is unidirectionally progressive left pneumonectomy + mediastinal lymph node dissection. The layers of structure are treated one after another until the fissure from a single direction through the working port. Hence, the resecting order should be left superior pulmonary vein—left lower pulmonary vein—left main bronchus—left pulmonary artery. The vessels and bronchi are cut using an endoscopic linear stapler or the Hemolock clips. The resected lobe is placed into a large-size specimen bag and retrieved through the working port to prevent contamination of the chest incision by any tumor tissue. Mediastinal lymph node dissection is performed at the end. The surgery is performed under general anesthesia with double-lumen endotracheal intubation. The patient is placed in a 90-degree position lying on the unaffected side. Similar to traditional resection of left lung lobes, an approximately 1.5-cm observation port is created in the 7th intercostal space between the middle and anterior Axillary Lines, an approximately 4-cm working port in the 4th intercostal space between the anterior Axillary line and the midclavicular line, and an approximately 1.5-cm auxiliary port in the 9th intercostal space between the posterior Axillary line and the subscapular line. The operator stands in front of the patient, manipulating the endoscopic instruments while watching the monitor.
Shuiwen Chen - One of the best experts on this subject based on the ideXlab platform.
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Lung ultrasonography for the diagnosis of meconium aspiration syndrome of the newborn infants
Chinese Journal of Applied Clinical Pediatrics, 2016Co-Authors: Jing Liu, Haiying Cao, Shuiwen Chen, Yan WangAbstract:Objective To investigate the diagnostic value of lung ultrasonography for meconium aspiration syndrome (MAS). Methods From August 2014 to October 2015, a total of 67 cases of MAS patients were included in this study based on the medical history, typical clinical symptoms and chest X ray findings.The control group comprised 100 neonates without pulmonary disease.In a resting state, each patient was placed in a supine, lateral recumbent, or prone position.Using the anterior and posterior Axillary Lines as boundaries, each side of the lung was divided into 3 regions: anterior, lateral and posterior.The probe was held perpendicular or parallel to the ribs, and each region of both sides of the lung was scanned. Results In this study, the main lung ultrasonographic findings in MAS patients were as follows: (1) Lung consolidation with air bronchograms, which was found in all patients.Generally, the large area of lung consolidation with irregular margins was seen in severe MAS patients while the small area of lung consolidation was seen in mild patients.(2)Pleural line anomalies and the disappearance of the A-Lines, which were found in all patients.(3)Atelectasis, which was found in 12 severe cases(17.9%), with severe massive atelectasis and visible lung pulse.(4)Pleural effusion, which was found in 9 cases (13.4%) including mild or severe patients.(5)Alveolar-interstitial syndrome (AIS) or B-line in the non-consolidation area was found in all patients. Conclusions There were speci-fic imaging findings in lung ultrasound in MAS patients. Lung ultrasonography can be used for the routine diagnosis of MAS because of its accuracy, reliability, low-cost and simplicity, no risk of radiation damage as well as it is convenience to observe and understand the dynamic changes of the patients′ condition timely. Key words: Lung ultrasonography; Meconium aspiration syndrome; Infant, newborn
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the diagnosis of neonatal pulmonary atelectasis using lung ultrasonography
Chest, 2015Co-Authors: Jing Liu, Shuiwen Chen, Fang Liu, Xiangyong Kong, Zhichun FengAbstract:Abstract BACKGROUND: Ultrasonography has been used for the diagnosis of many kinds of lung conditions, but few studies have investigated ultrasound for the diagnosis of neonatal pulmonary atelectasis (NAP). In this study, we evaluated the usefulness of lung ultrasonography for the diagnosis of NPA. METHODS: From May 2012 to December 2013, 80 neonates with NPA and 50 neonates without lung disease were enrolled in this study. Each lung of every infant was divided into the anterior, lateral, and posterior regions by the anterior and posterior Axillary Lines. Each region was scanned carefully with the probe perpendicular or parallel to the ribs. The ultrasound findings were confirmed by chest radiograph (CXR) or CT scan. RESULTS: Sixty of the 80 patients with signs of NPA on lung ultrasound also had signs of NPA on CXR (termed focal-type atelectasis), and the other 20 patients had signs of NPA on chest CT scan while there were no abnormal findings on CXR (termed occult lung atelectasis). In patients with NPA, the main ultrasound findings were large areas of lung consolidation with clearly demarcated borders, air bronchograms, pleural line abnormalities, and absence of A-Lines, as well as the presence of lung pulse and absence of lung sliding on real-time ultrasound. The sensitivity of lung ultrasonography for the diagnosis of NPA was 100%, whereas the sensitivity of CXR was 75%. Large areas of lung consolidation with clearly demarcated borders were only observed in patients with NPA. CONCLUSIONS: Lung ultrasonography is an accurate and reliable method for diagnosing NPA; most importantly, it can find those occult lung atelectasis that could not be detected on CXR. Routine lung ultrasonography is a useful method of diagnosing or excluding NPA in neonates.